Bladder cancer

Question 1

Perioperative chemotherapy(neoadjuvant or adjuvant)
Standard regimen

Answer 1

• DDMVAC (dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin) with growth factor support for 3 or 4 cycles
• Gemcitabine and cisplatin for 4 cycles
• CMV (cisplatin, methotrexate, and vinblastine) for 3 cycles

Question 2

First-line chemotherapy for locally advanced or metastatic disease
Cisplatin eligible(Standard regimen)

Answer 2

• Gemcitabine and cisplatin4 (category 1)

- DDMVAC with growth factor support (category 1)

Question 3

First-line chemotherapy for locally advanced or metastatic disease
Cisplatin ineligible with poor kidney function or poor PS

Answer 3

Standard regimen
- Gemcitabine and carboplatin

Alternate regimen for select patient

• Gemcitabine
• Gemcitabine and paclitaxel

Question 4

First-line chemotherapy for locally advanced or metastatic disease
Cisplatin ineligible due to hearing/ neuropathy but with good kidney function, and good PS

Answer 4

Alternate regimen for select patient

-Ifosfamide, doxorubicin and gemcitabine

Question 5

Second-line systemic therapy for locally advanced or metastatic disease

Answer 5

Standard regimen

• Atezolizumab
• Paclitaxel or docetaxel
• Gemcitabine
• Pemetrexed

Question 6

Second-line systemic therapy for locally advanced or metastatic disease

Answer 6

Alternate regimen for select patient 
Nab-paclitaxel
Ifosfamide
Methotrexate
Ifosfamide, doxorubicin, and gemcitabine
Gemcitabine and paclitaxel
Gemcitabine and cisplatin
DDMVAC

Question 7

Radiosensitizing chemotherapy regimens for bladder-preserving chemoradiation following a maximal TURB
First line chemotherapy

Answer 7

Standard regimen

• Cisplatin and 5-FU
• Cisplatin and paclitaxel
• 5-FU and mitomycin

Alternate regimen

• Cisplatin alone
• Low-dose gemcitabine(category 2B)

Question 8

Radiosensitizing chemotherapy given concurrently with conventionally fractionated radiation for palliation of metastases or for pelvic recurrence after cystectomy

Answer 8

• Cisplatin
• Taxane (docetaxel or paclitaxel) (category 2B)
• 5-FU (category 2B)
• 5-FU and mitomycin (category 2B)
• Capecitabine (category 3)
• Low-dose gemcitabine (category 2B)